In-home care in the final weeks

What does home-based palliative care provide?

Community palliative care teams are the backbone of end-of-life care at home. A community palliative care team typically includes specialist nurses (who visit regularly and are reachable by phone at all hours), palliative care doctors, social workers, and allied health professionals. Together, they manage pain and symptoms, provide equipment, support the family, and ensure there is always someone to call.

The frequency of nursing visits increases as needs increase. In the weeks before death, daily visits are common in most metropolitan areas. In regional areas, the frequency may be lower, but phone access to specialist advice is always available.

If you are not yet connected to a community palliative care service, ask your treating specialist or GP for a referral now. Do not wait for a crisis. The earlier the team is involved, the better the care.

What after-hours support is available at home?

Every community palliative care service has an after-hours phone line. This is one of the most important pieces of information you need to have in the final weeks. Write the number down and put it on the fridge, by the bed, and in your phone contacts.

When something changes at 2am, calling the palliative care after-hours line is almost always the right first call, not 000. The palliative care nurse can advise whether the change is expected, can adjust medications remotely in many cases, and can come to the house if needed. Calling 000 can result in an ambulance attending and an emergency department admission that no one wanted.

The exception: if the person is in severe distress that the palliative care team cannot immediately address, or if there is a safety emergency, 000 is appropriate. Your palliative care team will tell you specifically what warrants an ambulance call for your particular situation.

What home nursing and personal care services are available?

Skilled home nursing can provide wound care, medication management, catheter care, IV fluids or medications, and regular clinical assessment. Personal care workers assist with showering, dressing, oral hygiene, and other daily activities when the person can no longer manage independently.

These services are separate from the palliative care team and are usually arranged through My Aged Care for people over 65, through NDIS for eligible people under 65, or through private providers. Your palliative care social worker can help arrange the right combination of services for your situation.

On 1 November 2025, a new government program called Support at Home replaced Home Care Packages. It includes a dedicated End-of-Life Pathway with short-term, higher-level funding to help people assessed as being in their final months stay at home. Because funding amounts and details are still settling in, check My Aged Care for the current program and funding that apply to you.

What equipment do I need to prepare the home?

As the illness progresses, the home typically needs to accommodate changing physical needs. Common equipment includes a hospital-grade bed (which can be adjusted electronically and is far easier for carers to manage than a standard bed), a pressure-relieving mattress, a commode, a shower chair, a handheld urinal, and a hoist or transfer board if mobility is significantly reduced.

Most of this equipment can be hired or borrowed rather than purchased. Your palliative care nurse or occupational therapist can assess what is needed and arrange it. Do not wait until it is urgently needed to request equipment, as there can be short delays in delivery.

Think also about where the bed should be positioned: ideally in a room that is accessible, has good natural light, allows space for visitors to sit comfortably, and is close to a bathroom. Moving the bed to a ground floor room or a larger room often makes care significantly easier.

How is pain and symptom management handled at home?

Good symptom management in the final weeks requires regular reassessment, because what is working one week may not be working the next. Be specific with the palliative care team about pain levels, nausea, breathlessness, restlessness, and any other symptoms that are affecting comfort. Do not accept inadequate symptom control as unavoidable.

A syringe driver, a small device that delivers continuous medication under the skin, is often introduced in the final days or weeks when oral medication is no longer manageable or effective. Your palliative care nurse will manage this and explain what it involves. It is a routine and highly effective part of end-of-life care at home.

Keep a stock of "breakthrough" medication at home. This is medication for sudden increases in symptoms between regular doses. Your palliative care team will prescribe this. Make sure you know where it is kept and how to administer it, or know which nurse to call for guidance.

What support is available for carers at home?

Caring for someone at home through the final weeks is one of the most demanding things a person can do. Physically, emotionally, and practically, it is exhausting. The palliative care team's support is for the carer as much as for the person who is dying.

Tell the palliative care team how you are doing. Tell them if you are not sleeping, if you are overwhelmed, if you are afraid, or if you are not sure you can continue. They will not judge you. They will help. Carers who are not supported cannot provide good care, and the palliative care team knows this.

See the carer support guide and the respite care guide for more on maintaining your own wellbeing through this period.

What happens when home care is no longer possible?

For some families, home-based care reaches a point where it is no longer safe or manageable. This can be due to the carer's health or capacity, the complexity of care needs, or the person's own wish to be somewhere with more clinical support around them.

This is not a failure. It is a recognition that circumstances have changed. If home care is becoming unmanageable, speak honestly with the palliative care team. They can help plan a transition to inpatient palliative care or a hospice, which will provide a higher level of clinical support while still focusing entirely on comfort and quality of life.